Meeting with Insurance During a Winston-Salem Workers’ Comp Claim
Businesses that employ three or more employees are generally required to provide workers’ compensation benefits and to obtain workers’ compensation insurance. This means that for a majority of workers who suffer workplace injuries, they will be meeting with insurance during a Winston-Salem workers’ comp claim.
Meeting with an insurance company agent or adjuster can be a stressful experience, and often adjusters will request a recorded statement that may be used to approve or deny a workers’ compensation claim. It is important for workers to recognize that insurance companies are a business and as part of their business they need to keep their costs down.
This means that in a meeting with insurance during a Winston-Salem workers’ comp claim, the insurance company’s adjuster is going to be striving to settle the case for the lowest possible amount. Workers should be cautious of accepting any settlement offer for a workers’ compensation claim until they consult with an experienced attorney.
Starting the Process
After a workplace injury, the first steps are to report the injury to the employer by filling out Form 18 and to seek the proper medical treatment. In many cases, an employer will then report the injury to their insurance company.
After the insurance company becomes aware that there is a pending workers’ compensation claim, it is very typical for an adjuster to make outreach to the injured worker.
In this outreach, the adjuster will often ask a worker to make a statement detailing how the injury occurred, where the injury occurred, what the employee was doing at the time the injury occurred. It is important that workers’ take the time to answer these questions carefully, truthfully, and as thoroughly as possible.
However, it is also important to be wary of these statement sessions, as adjusters will often try and ask questions in a way to minimize a workers’ injury or to deny a claim entirely.
Examining Medical Records
In addition to this statement, the insurance company will also need access to an employee’s medical records so that the insurance company can review the injury and any diagnoses. An insurance company will meticulously review a workers’ medical records and look for inconsistencies such as how and where an injury occurred. Examining the medical records is an important part of meeting with insurance during a Winston-Salem workers’ compensation claim.
Settlement Negotiations With Insurance Companies
In the event that a worker has suffered an injury that results in a permanent disability, they will be assigned a disability rating after they have reached their maximum medical improvement permanent. The insurance company can then create a Form 26A utilizing the doctor’s information, which establishes the settlement amount of a case.
At this point in the proceeding, it is very common for insurance companies to offer a settlement offer. However, one of the biggest mistakes workers make is that they do not challenge the disability rating.
This can be crucial because the settlement amount an insurance company will offer is based on a formula that includes compensation rates depending on the body part and degree of disability. Insurance companies, therefore, want a low disability rating so they do not have to pay as much. However, a worker can challenge this rating and thereby receive a higher settlement offer.
Working With an Attorney
Before meeting with insurance during a Winston-Salem workers’ comp claim, contact a dedicated and experienced lawyer today. A seasoned workers’ compensation lawyer is familiar with the high-pressure tactics of insurance companies and will not be intimidated, but will fight for your right to fair and adequate compensation.
